Oversight and Investigations Subcommittee Continues Examination of U.S. Mental Health System

May 22, 2013

WASHINGTON, DC – The Subcommittee on Oversight and Investigations, chaired by Rep. Tim Murphy (R-PA), today held a hearing examining the role of the Substance Abuse and Mental Health Services Administration (SAMHSA), and specifically the Center for Mental Health Services (CMHS), in addressing the challenges posed by severe mental illness (SMI). This hearing continues the committee’s post-Newtown examination of mental health programs and federal resources available to individuals with serious mental illnesses. In early May, committee leaders requested additional information from SAMHSA Administrator Pamela Hyde on the agency's grant program.

"The Center for Mental Health Services, housed at SAMHSA, has a budget of approximately $1 billion per year. It awards most of these funds through a combination of competitive and formula grants. I’m concerned, because the committee has seen substantial evidence that too many of these grants are directed to advancing services rooted in unproven social theory and feel-good fads, rather than science," said Chairman Murphy. "As an agency of the U.S. Public Health Service, we expect SAMHSA’s work to be firmly rooted in evidence-based practices, enduring high-level scientific peer review at the hands of licensed mental health professionals. Perhaps some of it is but much of it appears to fall far short of such standards."

Full committee Chairman Fred Upton (R-MI) said, “While the vast majority of individuals with a mental health condition are nonviolent, in March, the subcommittee learned from Dr. Tom Insel, Director of the National Institute of Mental Health, the important fact that treatment can reduce the risk of violent behavior fifteen-fold in persons with serious mental illness.”

Dr. Sally Satel, Resident Scholar at the American Enterprise Institute, explained that SAMHSA and the CMHS suffer from a lack of psychiatric experts in leadership roles as well as an ideology that does not adequately and properly serve all patients. “The agency’s guiding ideology leads it to overlook millions of people with long-term psychotic disorders. Very few SAMHSA programs help reduce the impact of mental illness on the communities – that is, on rates of incarceration, homelessness, and dangerousness,” said Satel. “The agency’s relative neglect of those with severe mental illness is only part of the problem. As the testimony of other panelists will make clear, the agency also supports activities that actively sabotage their welfare. This is strong language, I am aware. I refer here to CMHS’s seemingly uncritical support of both ‘consumer’ groups and legal aide workers (though its Protection and Advocacy, PAIMI, program) who either condemn the use medications or are hostile to formal psychiatric care. The efforts of these advocates have been decidedly harmful to patients with schizophrenia and other psychotic illnesses.”

Dr. E. Fuller Torrey, Founder of the Treatment Advocacy Center, implored the committee to take action to improve the work that SAMHSA does. “What I wish to emphasize most strongly is that this failure has consequences that affect us all, “ said Torrey. “The important issue is what SAMHSA is not doing to improve the broken mental illness and substance abuse treatment system in the United States. Because people with severe mental illnesses are not receiving treatment, tragedies occur every day of which Tucson, Aurora and Newtown are merely the most prominent.”

Providing members an example of the tragedies that can occur from failures in the mental health system, Joe Bruce told the subcommittee of the tragic, and what he believes to have been preventable, murder of his wife committed by their son, Will, who suffers from severe mental illness. “Tragedy visits families every day. That is a sad fact of life. But an unbearable aspect of Amy’s death is that my own tax dollars helped make it possible. A retired nurse from Riverview may have summed it up best. She wrote: 'Mr. Bruce . . . Your losses didn’t happen for reasons other than your family’s misfortune to become involved with the mental health system, when politics (now) override sound medical decisions.'"

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